Electrosurgical instrument

ABSTRACT

An electrosurgical instrument comprising a first arm carrying at least a first and optionally a second and third electrode, and a second arm opposing the first arm, the second arm carrying one of a nonconductor element or one or more conductive elements.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is related to and claims the benefit of the filing dateof U.S. Provisional Application Ser. No. 61/787,731 filed Mar. 15, 2013,the contents of this application being hereby incorporated by referencefor all purposes.

FIELD

The present teachings generally relate to electrosurgical instrument tiparrangements for use in both bipolar and combination monopolar/bipolardevices. More specifically, the present teachings address thearrangement of multi-electrode electrosurgical tip designs.

BACKGROUND

Typically, electrosurgical instruments have stand-alone monopolarcapabilities or bipolar capabilities. Combination devices that can beutilized in both monopolar and bipolar mode have also been developed.Based upon the operational needs of each type of device, differentelectrosurgical device tip designs are generally utilized for each ofstand-alone monopolar, bipolar, or combination monopolar/bipolardevices.

Some examples of such electrosurgical instrument tip arrangements may befound in U.S. Pat. Nos. 5,403,312; 6,030,384; 6,113,596; 6,458,128;6,926,716; and 7,604,635, all of which are incorporated by referenceherein for all purposes. It would be desirable to have anelectrosurgical device tip design that provides improved function for astand-alone bipolar device and may also be utilized for a combinationmonopolar/bipolar device. It would be further beneficial to have anelectrosurgical device that may be used in open surgery as forceps andmay be used for electrical cutting and/or hemostasis.

SUMMARY

The present teachings meet one or more of the needs identified herein byproviding an electrosurgical instrument comprising a first arm carryinga first and second electrode and an optional third electrode, whereinthe first and second electrode are optionally two integrally formeddiscrete conductors. The instrument may further include a second armopposing the first arm, the second arm carrying one of a nonconductorelement or one or more conductive elements. Only one of the firstelectrode, second electrode, third electrode, or one or more conductiveelements may pass energy in a monopolar mode and at least two of thefirst electrode, second electrode, or one or more conductive elementsmay pass energy in a bipolar mode.

In another embodiment of the present teachings, the instrument maycomprise a first arm carrying a first and second electrode and anoptional third electrode and a second arm opposing the first arm, thesecond arm carrying one or more electrodes. The first arm, the secondarm or both may include a plurality of electrodes free of direct contactwith one another but in electrical connectivity with one another to passenergy in a monopolar mode and at least two of the first electrode,second electrode, or one or more electrodes of the second arm passenergy in a bipolar mode.

Another possible embodiment of the present teachings comprises anelectrosurgical instrument comprising a first arm carrying a first andsecond electrode and a second arm opposing the first arm, the second armcarrying a conductive element. The conductive element may be a floatingelectrode so that a preferential path is created for energy flow fromone or more of the first and second electrode via the floating electrodein bipolar mode.

Yet another embodiment addressed by the present teachings includes anelectrosurgical instrument comprising a first, arm carrying a firstelectrode and a second arm opposing the first arm, the second armcarrying a second electrode. Only one of the first electrode or secondelectrode may pass energy in a monopolar mode and both of the firstelectrode and second electrode may pass energy in a bipolar mode.

Another embodiment addressed by the teachings herein includes anelectrosurgical instrument comprising a first arm carrying a firstelectrode and a second arm opposing the first arm, the second armcarrying a second electrode. At least a portion of one or more of thefirst electrode and second electrode may pass energy in a monopolar modeand at least a portion of one or more of the first electrode and secondelectrode may pass energy in a bipolar mode. At least a portion of oneor more of the first electrode and second electrode passes energy inmonopolar mode and extends from a spine or side edge of at least one ofthe first or second arms.

The teachings herein further provide for an electrosurgical instrumentcomprising a first arm carrying a first electrode, a second arm opposingthe first arm, the second arm carrying a second electrode, a thirdelectrode, and optionally one or more additional electrodes. The firstelectrode and second electrode may pass energy in a monopolar mode andat least two of the first electrode, third electrode, or one or moreadditional electrodes may pass energy in a bipolar mode.

The teachings herein provide for electrosurgical instrument tiparrangements that may be utilized in both bipolar and combinationmonopolar/bipolar devices. The teachings herein further provide forelectrosurgical instrument tip arrangements that may be used in opensurgery as forceps and may be used for electrical cutting and/orhemostasis. The teachings herein also provide for tip arrangementsincluding a plurality of electrodes and insulating portions forfacilitating improved energy flow depending upon the need for cutting orhemostasis and the monopolar or bipolar nature of the energy facilitatedthrough the tips.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an illustrative example of a tip arrangement of anelectrosurgical instrument in accordance with the present teachings.

FIG. 2 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 3 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 4a shows a cross-sectional view of the tip arrangement of FIG. 2when contacting a tissue sample.

FIG. 4b shows a cross-sectional view of the tip arrangement of FIG. 3when contacting a tissue sample.

FIG. 5a shows an illustrative example of a tip arrangement andelectrical circuit of an electrosurgical instrument in accordance withthe present teachings.

FIG. 5b shows an additional illustrative example of a tip arrangementand electrical circuit of an electrosurgical instrument in accordancewith the present teachings.

FIG. 6a shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 6b shows an additional illustrative example of a tip arrangementand electrical circuit of an electrosurgical instrument in accordancewith the present teachings.

FIG. 6c shows an additional illustrative example of a tip arrangementand electrical circuit of an electrosurgical instrument in accordancewith the present teachings.

FIG. 7 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 8a shows an additional illustrative example of a tip arrangement ofelectrosurgical instrument in accordance with the present teachings.

FIG. 8b shows an additional illustrative example of a tip arrangementand electrical circuit of an electrosurgical instrument in accordancewith the present teachings.

FIG. 8c shows an additional illustrative example of a tip arrangementand electrical circuit of an electrosurgical instrument in accordancewith the present teachings.

FIG. 9 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 10 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 11a shows an example of a tip arrangement and electrical circuit ofan electrosurgical instrument in accordance with the teachings in theprior art.

FIG. 11b shows an example of a tip arrangement and electrical circuit ofan electrosurgical instrument in accordance with the teachings in theprior art.

FIG. 12a shows an example of a tip arrangement and electrical circuit ofan electrosurgical instrument in accordance with the teachings in theprior art.

FIG. 12b shows an example of a tip arrangement and electrical circuit ofan electrosurgical instrument in accordance with the teachings in theprior art.

FIG. 13 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 14 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 15 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 16 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 17 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 18 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 19 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 20 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 21a shows an additional illustrative example of a tip arrangementof an electrosurgical instrument in accordance with the presentteachings.

FIG. 21b shows an additional illustrative example of a tip arrangementand electrical circuit of an electrosurgical instrument in accordancewith the present teachings.

FIG. 22a shows an additional illustrative example of a tip arrangementof an electrosurgical instrument in accordance with the presentteachings.

FIG. 22b shows an additional illustrative example of a tip arrangementand electrical circuit of an electrosurgical instrument in accordancewith the present teachings.

FIG. 23 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 24 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 25 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 26 shows an additional illustrative example of a tip arrangement ofan electrosurgical instrument in accordance with the present teachings.

FIG. 27a shows an additional illustrative example of a tip arrangementof an electrosurgical instrument in accordance with the presentteachings.

FIG. 27b shows an additional illustrative example of a tip arrangementof an electrosurgical instrument in accordance with the presentteachings.

DETAILED DESCRIPTION

This application claims the benefit of the filing date of U.S.Provisional Application Ser. No. 61/787,731 filed Mar. 15, 2013, andU.S. Provisional Application No. 61/902,933, filed Nov. 12, 2013 thecontents of these applications being hereby incorporated by referencefor all purposes.

The explanations and illustrations presented herein are intended toacquaint others skilled in the art with the teachings, its principles,and its practical application. Those skilled in the art may adapt andapply the teachings in its numerous forms, as may be best suited to therequirements of a particular use. Accordingly, the specific embodimentsof the present teachings as set forth are not intended as beingexhaustive or limiting of the teachings. The scope of the teachingsshould, therefore, be determined not with reference to the abovedescription, but should instead be determined with reference to theappended claims, along with the full scope of equivalents to which suchclaims are entitled. The disclosures of all articles and references,including patent applications and publications, are incorporated byreference for all purposes. Other combinations are also possible as willbe gleaned from the following claims, which are also hereby incorporatedby reference into this written description.

The present teachings are directed toward electrosurgical instrument tiparrangements. The tips are generally those associated withelectrosurgical forceps. The electrosurgical instruments upon which thetips are located may be any device that may be used by a surgeon toperform a surgical procedure. The electrosurgical device may be used tocut, perform hemostasis, coagulate, desiccate, fulgurate,electrocauterize, or any combination thereof. The electrosurgicalinstrument tips may be integrated with any device that includes bipolarcapabilities or both bipolar capabilities and monopolar capabilities.The electrosurgical instrument tips are preferably utilized in eitheropen or laparoscopic surgery as opposed to solely laparoscopicprocedures.

The instrument tips may be utilized in combination monopolar/bipolardevices. When in a monopolar configuration (e.g., when included in acombination monopolar/bipolar device) one or more of the plurality ofelectrodes may receive power through the device and a return electrodemay be located at another location outside of any hand-held portion ofthe electrosurgical instrument. Alternatively, two or more electrodesmay be integrally formed or in electrical connectivity with one anotherto function as monopolar electrode. A monopolar configuration may bedesired to cut tissue, apply power to a large area, or a combinationthereof. Any use of the instrument tips described herein in monopolarmode may be for the purpose of dissection, less delicate procedures,less localized electrosurgery, or both when compared to bipolarelectrosurgery.

The instrument tip when in a bipolar configuration (e.g., as part of astand-alone bipolar device or as part of a combination monopolar/bipolardevice) may be arranged such that one of a plurality of electrodesreceives power and that power transfers to a second adjacent and/oropposing electrode creating a path for the power that is relativelyshort when compared to the path in the monopolar configuration. In apreferred bipolar configuration, the instrument tip may include twoelectrodes on a first surface and one electrode (e.g., one conductiveportion) on an opposing second surface. In yet another preferred bipolarconfiguration, the instrument tip may include a first bipolar electrodeon a first surface and a second bipolar electrode on a second opposingsurface. The surfaces may be configured as forceps including first andsecond arms such that a first arm carries the first surface and a secondarm carries the second surface. One or more electrodes or any otherconductive portion may be located in opposing relationship with one ormore additional electrodes or conductive portions. One or moreelectrodes may be located on non-opposing (e.g., outside edge) surfacesof the arms of the instrument tip. It is understood that conductiveportions may be electrodes or may simply be conductive in nature and notoperating as an electrode.

The instrument tips may be forceps instrument tips. The forceps may beany forceps that may be used to grip, hold, squeeze, or a combinationthereof one or more objects. The forceps may include one or more fingergrips (i.e., configured like scissors) that may be used to move theforceps so that they may be used to grip one or more objects. Theforceps may be free of finger grips and be actuated by direct pressurebeing applied to opposing sides of the forceps so that the forceps closeand grip an object. The forceps include the first and second arms.

Each arm may include one or more surfaces that form the instrument tiparrangements described herein. As mentioned above, the instrument tipsmay be configured in one or more electrosurgical configurations (e.g., amonopolar configuration, bipolar configuration, or a combination ofboth). In addition to the arrangement of the tip surfaces as describedherein, the tips may include teeth, serrations, mouse teeth, free ofteeth (i.e., smooth), or any combination thereof. The instrument tipsmay include a plurality of conductive portions which may include one ormore electrodes and one or more insulating portions. Preferably, the tipregion includes insulation on the non-contact portions of the arms sothat electrosurgical energy is not transferred through incidentalcontact. The arms may include an active portion (e.g., a conductiveportion) and an inactive portion (e.g., an insulated portion).

The active portion may be any portion of the device that may be used toapply power or facilitate the flow of energy. The active portion may bethe same portion as the electrodes on the surfaces of the arms. Thus,for example, when tissue is grasped between the first and secondsurfaces (e.g., contact portions) of the arms, power may be supplied tothe tissue through this contact portion. Energy may thus flow throughone or more of the first and second surfaces and into and/or onto thetissue. The active portions may be substantially surrounded by inactiveportions or portions that are insulated. The inactive portion may be anyportion that does not supply power, that is insulated, or both. Theinactive portion may be any portion that may transfer power throughincidental contact. For example, an outside portion of the arms may becoated with an insulating material so that if the arms accidentallycontact tissue proximate to the tissue of interest the proximate tissueis not subjected to a transfer of power. The inactive portion and theactive portion may be made of different materials, coated with differentmaterials, or both.

The arms may be made of any material that may be used to grip, hold,squeeze, or a combination thereof and provide monopolar power, bipolarpower, or a combination of both to a desired location. The arms may bemade of one material and at least a portion of the tip region of eacharm may include or be coated with one or more materials that may beinsulating. At least a portion of the tip region of one or both of thearms may include a conductive material. The conductive material may beformed as a coating having a higher conductivity than a base material.The conductivity of a given portion of the arm may have a higher orlower conductivity than an adjacent portion of the arm. The one or morearms may include one or more materials along the length of the arm. Forexample, the arms may be entirely made of stainless steel. Preferably,each arm includes two or more materials. For example, the arms may havea base material of stainless steel and at least a portion of the armsmay be coated with an insulating material such as silicone orpolytetrafluoroethylene (PTFE). The arms may include any material thatis safe for use in a surgical procedure, and preferably anelectrosurgical procedure. The arms may include metals, plastics,polymers, elastomers, gold, silver, copper, titanium, aluminum, ironbased metals, stainless steel, silicone, polytetrafluoroethylene (PTFE),insulating polymers, rubber, or a combination thereof. Preferably, eacharm is substantially coated with an insulating material except for acontact region where an arm directly contacts a second arm. The arms maybe coated in regions where the user contacts the arms. The arms may havean active portion and a passive portion. For example, the active portionmay be a metal that extends through the arms and is used to providemonopolar energy, bipolar energy, gripping capabilities, holdingcapabilities, squeezing capabilities, or a combination thereof. Thepassive portion may be a portion that houses the active portion. Thepassive portion may be a housing.

The arms may be located within a housing. The housing may be any devicethat may include one or more arms and be gripped by a user during use.The housing may provide for electrical connection, mechanical connectionor a combination thereof between two or more arms. The housing may be apivot point so that the two arms may be moved when the housing iscompressed. The housing may substantially surround the arms so that onlythe tip region including the tip portions extends out of the housing andis exposed. The housing may surround an outer surface of the arms and aninner surface of the arms may be exposed. The housing may beelectrically connected to a power source and provide power to each ofthe arms. The housing may be electrically insulating. The housing mayinclude one or more activation buttons, one or more printed circuitboards and associated controls, one or more monopolar electrodes, one ormore bipolar electrodes, one or more shields, one or more channels, or acombination thereof.

The monopolar electrode may be any device that may be used to applymonopolar power during a procedure. The monopolar electrode may be aseparate piece that when activated may be used to supply monopolarpower. A monopolar electrode may be formed on only one arm. A monopolarelectrode may be formed on both arms. The monopolar electrode may belocated on or adjacent an inner edge surface of an arm of the device.The monopolar electrode may be located on or adjacent an outer edgesurface of the arm of the device. The monopolar electrode may operate inmonopolar mode upon receiving monopolar energy. A portion of themonopolar electrode may also operate as part of a bipolar electrodesystem. The monopolar electrode may be located on one surface of one armalong with a second electrode. The monopolar electrode may be used forelectrically cutting.

One or more of the electrodes (e.g., the first, second, third, fourth orany additional electrode) may be made of the same material as one orboth of the arms. Preferably, the arms and the one or more electrodesare made of different materials. The one or more electrodes may be madeof one material. Preferably, the one or more electrodes include two ormore materials. The one or more electrodes may be formed of two or moreintegrally formed electrodes (e.g., discrete conductors) having a jointformed therebetween. In one embodiment, one of the two integrally formedelectrodes may allow for better thermal dissipation while the otherallows for reduced thermal dissipation. The one or more electrodes maybe made of stainless steel, copper, silver, titanium, a metal, asurgical steel, a metal with good thermal dissipation properties, ametal with reduced thermal dissipation properties, or a combinationthereof. The one or more electrodes (or a portion thereof) may include acoating. The coating may be any coating that provides insulatingproperties, provides improved thermal dissipation, prevents corrosion,or a combination thereof. The coating may be a polymer, an elastomer,silicone, polytetrafluoroethylene (PTFE), the like, or a combinationthereof. The coating may extend over substantially the entirety of theone or more electrodes except for the active region of the one or moreelectrodes. The one or more electrodes may include one or more electrodeinsulators.

Any electrode insulator may be formed of a material that may insulateall or a portion of the active portions of the arms. The electrodeinsulator may prevent undesired contact of tissue with the electrodewhen the electrosurgical device is in use. The electrode insulator mayprevent power from being transferred from one or both of the arms to theone or more electrodes.

A first electrode may be located on a first surface which is formed onthe first arm. The first electrode may be located along an inner surfaceof the first arm. The first electrode may extend from one or moreoutside surfaces of the first arm. The first electrode (or any of theelectrodes) may be located along the inner surface of the first arm andmay also extend from an outside surface of the first arm. The first armand first surface may include a first and second electrode. The secondelectrode may extend from an outside surface of the first arm. Thesecond electrode (or any of the electrodes) may be located along theinner surface of the first arm and may also extend from an outsidesurface of the first arm. The second electrode may be substantially freeof any direct contact (e.g., direct physical contact as opposedelectrical contact) with the first electrode. The first and secondelectrodes (or any combination of electrodes) may be integrally formeddiscrete conductors which may have a joint formed therebetween. Thefirst and second electrodes (or any combination of electrodes) may be inelectrical communication with one another for operating together as anelectrode. One or more of the first and second electrode may be abipolar electrode. One or more of the first and second electrode may bea monopolar electrode. One or more of the first and second electrode mayfunction as both a monopolar electrode and a bipolar electrode. Thefirst and second electrodes may be located adjacent each other forforming the first surface. The first arm may also include a thirdelectrode, which may also be located on the first surface of the firstarm or may extend from an outside edge of the first arm. The thirdelectrode may be adapted for operation in monopolar mode only, bipolarmode only, or may be adapted for both monopolar and bipolar use. Any ofthe first, second or third electrodes may include an insulating portionlocated adjacent one or more terminal edges of the electrode, wherebysuch insulating portion is located in between one or more electrodes.The size of the insulating portion between the one or more electrodes(e.g., the distance between the one or more electrodes) must besufficiently large to prevent direct contact between the one or moreelectrodes. The size of the insulating portion between the one or moreelectrodes may be small enough so that power can flow from one electrodeto another electrode, generally via a portion of tissue.

A second surface may oppose the first surface and may be located on thesecond arm. The second surface may include one or more conductiveelements which may be an electrode. The second surface may also includean insulating portion. The insulating portion may be located adjacentthe conductive element on at least one edge of the conductive element.The insulating portion may be located along at least two edges of theconductive element. The insulating portion may be located along at leastthree edges of the conductive element. Alternatively, the second surfacemay be substantially free of any conductive element. The second surfacemay consist essentially of an insulating portion. The conductive elementon the second surface may be an electrode located along the innersurface of the second arm and may oppose one or more electrodes on theinner surface of the first arm. The conductive element may be anelectrode located along an outside edge of the second arm. Two or moreconductive elements may be located along the inner surface of the secondarm and may also extend from an outside surface of the second arm. Theconductive element may be an electrode that is adapted for operation inmonopolar mode, bipolar mode, or both monopolar and bipolar mode.

The first arm may include a first electrode, which may operate inmonopolar mode, bipolar mode, or both monopolar and bipolar mode. Thefirst electrode may be located along an inner surface of the first arm,but a portion of the first electrode may also extend from one or moreside edges of the arm or even a back edge (e.g., spine portion) of thearm. The first electrode may extend from multiple side edges of thefirst arm. The second arm may include a second electrode and energy maypass from the first electrode on the first arm to a second electrode onthe second arm when used in bipolar mode. In the same arrangement, aswitch may be activated so that only the first electrode passes energywhen in monopolar mode (or alternatively only the second electrodepasses energy in monopolar mode). The first arm may include a firstelectrode and the second arm may include an opposing second electrodesuch that both of the first and second electrodes are located along aninner surface portion of each of the first and second arms and both ofthe first and second electrodes include an extension portion extendingfrom a side edge or back edge of each of the first arm and second arm.Energy may pass from the first electrode to the second electrode inbipolar mode. Each of the extension portions may pass energy inmonopolar mode.

The first arm may include a first and second electrode. One or more ofthe first and second electrodes may operate in bipolar mode. One or moreof the first and second electrodes may operate in monopolar mode. One ormore of the first and second electrodes may operate in both bipolar andmonopolar mode. The second arm may include only insulating material andmay be substantially free of any conductive portion (e.g., electrode).The second arm may include one or more electrodes. The second arm mayinclude a first and second electrode. The first arm may include a thirdelectrode. The second arm may include a third electrode. Any electrodelocated on the first or second arm may be located on an inner surface ofthe arm or may be located (e.g., may extend from) an exterior surface ofthe arm which may be a side edge of the arm or a back edge (e.g., aspine portion) of the arm.

Any electrode may be formed of one material or of two or more materials.Two or more electrodes of the same or different material may also beintegrally formed as two discrete conductors to act as a singleelectrode. The two or more materials may be selected based upon desiredthermal dissipation of the electrode at different locations. As anexample, a low thermal dissipation material may be utilized for theelectrode through which energy flows during use of the device inmonopolar mode. Such material would allow that portion of the electrodeto heat thereby requiring less overall voltage. A high thermaldissipation material may be utilized for a second electrode. The twodiscrete conductors (low dissipation and high dissipation) may include ajoint located therebetween. The joint may provide a thermal insulationfunction such that the heating of the lower thermal dissipation materialdoes not cause heating of the high thermal dissipation material. In onenon-limiting example, the lower thermal dissipation material may includesteel and the high thermal dissipation material may include copperand/or silver.

The concept of a joint between two or more electrodes in an effort tocontrol heat and electricity transfer may also be utilized in electrodesformed of only one monolithic material. Such a joint may be formed bythe shaping of the conductive materials. More specifically, one or moreelectrodes may be formed to have a “bottle-neck” feature where thematerial for forming the electrode is indented and adjacent to two ormore lobes (see for example FIGS. 26a and 26b ). This indentation allowsfor thermal separation by allowing energy transfer but minimizing heattransfer between lobes. The joint may be in the form of a wave shapedribbon which may be pressed into slot located along the tip. The jointmay be formed as flat ribbon pressed into a slot with knobs. The slotalong the tip may be filled with epoxy, putty, or filler to hold theribbon in place.

In one embodiment, in the event that the conductive element is afloating electrode, the interaction between the first and second bipolarelectrodes located along the inner surface of the first arm and thefloating electrode may be such that energy flows through the firstbipolar electrode, towards the floating electrode and back to the secondbipolar electrode. During use, a tissue portion may be located betweenthe first and second inner surfaces (e.g., between the first and secondarms). Thus, energy may flow through the first bipolar electrode andthen flow to any combination of onto the tissue, into the tissue, orthrough the tissue. If the instrument receives a tissue in between thefirst and second arm during use in bipolar mode, bipolar energy travelsthrough at least a portion of the tissue when moving along an energypath between the first electrode, the floating electrode, and the secondelectrode. The second arm may include an insulation portion (as shownfor example in FIG. 4b ) so that bipolar energy travels through a largerportion of the tissue as compared to that of a second arm without theinsulation portion.

A first and second electrode may be located on the first of two opposingarms and a third electrode may be located on the second of the twoopposing arms. Alternatively, a first, second, and third electrode maybe located on the first arm. A first electrode may be located on thefirst arm and a second electrode located on the second arm. Thus, tissuelocated in between the two opposing arms may electrically connect thearms, form an electrical bridge between the two arms, or both. In theevent that the device is utilized in monopolar mode, the first arm mayhave a single monopolar electrode (which may the first, second, or thirdelectrode) and the tissue contacted by that electrode may electricallyconnect the monopolar electrode with a return electrode, act as anelectrical bridge between the monopolar electrode and the returnelectrode, or both. One or more of the electrodes may be combined toform a single potential in monopolar mode. In the event that the deviceis a combination monopolar/bipolar device, the circuit may include aswitch that switches between the monopolar configuration and the bipolarconfiguration. The switch may activate one of the bipolar electrodes anddeactivate the return pad or vice versa, activate one bipolar electrodeand deactivate the monopolar electrode or vice versa, deactivate onebipolar electrode and leave the electrode open not powered), deactivatethe monopolar electrode and leave the electrode open, deactivate bothbipolar electrodes and activate the monopolar electrode and the returnelectrode or vice versa, or a combination thereof. The monopolarelectrode (e.g., one of the first and second electrode), one or more ofthe bipolar electrodes (e.g., the first and second electrode), or acombination thereof may be connected to an alternating current powersource, a direct current power source, or both. Preferably, themonopolar electrodes, the bipolar electrodes, or both are connected toan alternating current power source. The monopolar electrode, thebipolar electrodes, or both may complete a circuit when in contact withtissue.

The device tip arrangements as described herein are designed forimproved function and interchangeability in a variety of deviceconfigurations. Each surface described may include specific materialshaving desired functions at selected locations to improve the functionof the device. Such materials may be selected and located depending onthe desired function of the device. For example, the second arm maycarry a nonconductor element and be substantially free of any conductivesurface, such that only the first arm includes conductive elements.Thus, the second arm may be free of any electrical connectivity andmerely provides a compressive force during a surgical procedure.Alternatively, the second arm carries a conductive element. Theconductive element on the second arm may act to improve the path ofenergy between the electrodes in bipolar mode. The conductive elementmay be a floating electrode so that a preferential path is created forenergy flow from one or more of the first and second electrode and thelocation of the path is easily modified by location of the floatingelectrode. Thus the energy may flow between the first electrode to thesecond electrode via the floating electrode in bipolar mode. The energymay flow from only one of the first or second electrode to a returnelectrode remote from but in electrical communication with the first armin monopolar mode.

One or more of the first and second arms may include insulated portions.The second arm may carry an insulation portion. This insulation portionmay be located so that it extends the length of an energy path betweenthe first and second electrode (see length (l) at FIGS. 2 and 3). Thefirst arm may include an insulation portion between the first and secondelectrodes. The second arm may include an insulation portion thatopposes the insulation portion between the first and second electrodeson the first arm.

FIG. 1 shows an illustrative arrangement for an electrosurgicalinstrument tip 10. The tip 10 includes a first arm 12 and a second arm14. The first arm 12 includes a first electrode 16. The first arm alsoincludes a second electrode 18. The second arm 14 may be free of anyelectrode and may have only a non-conductive component 22 and noconductive component. The first arm 12 may also include insulating(non-conductive) portions 28 a, 28 b, and 28 c, such that a firstinsulating portion 28 a is located adjacent a terminating edge of thefirst electrode. A second insulating portion 28 b may be located inbetween the first electrode and second electrode. A third insulatingportion 28 c may be located adjacent a terminating edge of the secondelectrode.

Alternatively, as shown in FIG. 2, the instrument tip 10 includes afirst arm 12 and a second arm 14. The first arm 12 includes a firstelectrode 16. The first arm also includes a second electrode 18. Thesecond arm 14 also includes an electrode 20 (e.g., a third electrode)which may be a floating electrode (e.g., may be free of any electricalconnection with any electrode or ground) or may be fixed at onepotential (e.g., electrically attached to the ground). The second armmay include one or more insulating (non-conductive) portions 28. Thesecond arm includes a first insulating portion 28 d which substantiallysurrounds the electrode 20 (e.g., the conductive portion) on the secondarm on at least one, two, or three sides. The electrode 20 may insteadbe coplanar with the first insulating portion 28 d or may extend beyondthe surface of the first insulating portion. As in the embodiment shownat FIG. 1, The first arm 12 may also include insulating (non-conductive)portions 28 a, 28 b, and 28 c, such that a first insulating portion 28 ais located adjacent a terminating edge of the first electrode. A secondinsulating portion 28 b may be located in between the first electrodeand second electrode. A third insulating portion 28 c may be locatedadjacent a terminating edge of the second electrode.

FIG. 3 illustrates an additional embodiment including a secondinsulating portion 26 located on the second arm. The addition of thesecond insulating portion 26 assists in directing energy from the firstelectrode 16 to the second electrode 18 via the third electrode 20 suchthat the flow of energy runs between the second insulating portion 26and first insulating portion 28 d of the second arm.

FIG. 4a depicts a cross-sectional view of an interface between theinstrument tip 10 of FIG. 2 and a tissue sample 30. As shown, the pathof energy 32 flows into the second electrode 18, through a portion ofthe tissue 30 toward the third electrode 20 and back to the firstelectrode 16.

FIG. 4b depicts an additional cross-sectional view of an interfacebetween the instrument tip 10 of FIG. 3 and a tissue sample 30. In thisembodiment, the inclusion of the second insulating portion 26 causes thepath of energy 32 to extend further into the tissue 30 as the secondinsulating portion acts to guide the energy further toward the thirdelectrode 20. The length of the second insulating portion 26 is alsoshown as longer than the length of the opposing insulating portion 28 b,thus further extending the path of energy 32.

FIG. 5a displays an instrument tip 10 and associated electricalconnections in use in bipolar mode. The first arm 12 includes a firstelectrode 16 and the second arm 14 includes a second electrode 18. Afirst extension portion 34 of the first electrode 16 extends from a sideedge 36 of the first arm. When used in bipolar mode, the path of energy32 moves between the first electrode and second electrode. The first andsecond electrodes are further connected via a circuit 38.

FIG. 5b shows the instrument tip of FIG. 5a in use in monopolar mode.The first and second electrodes (16, 18) are present, however there isno energy flow between the first and second electrode. The path ofenergy 32 flows instead through the extension portion 34 of the firstelectrode, through tissue (not shown), to a remote ground pad 40.

FIG. 6a shows an instrument tip 10 including a first electrode 16 on thefirst arm 12 and a second electrode 18 on the second arm 14. Both of thefirst and second electrodes include an extension portion 34 a, 34 bextending from a terminating side edge 36 a, 36 b of the first arm andsecond arm respectively. In such an arrangement both the first andsecond electrodes have the capability of operating in monopolar mode.

As shown in FIG. 6b , the instrument tip of FIG. 6a may be connected viaa circuit 38. When used in bipolar mode, the energy path 32 flowsbetween the first electrode 16 and second electrode 18 and the first andsecond electrode are connected to an energy source (and one another) viathe circuit 38. The first electrode 16 is connected to a power sourcevia a first connector 17, and the second electrode 18 is connected to apower source via a second connector (e.g., a second connector thatincludes connector portions 19 and 23). A third connector 21 isavailable, but does not provide connectivity when the device is used inbipolar mode.

FIG. 6c shows the instrument tip of FIGS. 6a and 6b in use in monopolarmode, whereby the circuit 38 no longer connects the first electrode 16and second electrode 18. As shown, both first extension portions 34 a,34 b of the first and second electrode are connected to a monopolarenergy source and the energy path 32 flows through each extensionportion, through tissue (not shown), to a remote ground pad 40. Asshown, during use in monopolar mode, the first and second electrodes arein electrical contact with one another such that a single monopolarenergy supply can provide for use of both extensions portions. Similarto the bipolar configuration shown at FIG. 6b , the first electrode isconnected to the power source via the first connector 17. However thesecond electrode is free of any connectivity to the power source via thesecond connector 19. However, the connector portion 23 that was part ofthe second connector in bipolar mode is connected to the power sourceand also now connected to the third connector 21 via a connector portion25.

As shown for example in FIG. 7, the instrument tip 10 may include afirst electrode 16 may include a first extension portion 34 and a secondextension portion 35. One or both of the first and second extensionportions may pass energy when in monopolar mode. The first electrode 16may also pass energy in bipolar mode such that a bipolar energy path 32flows between the first electrode 16 and second electrode 18.

A first extension portion 34 a, 34 b may extend from a spine portion 42of the instrument tip 10 as shown in FIGS. 8a-8c . FIG. 8a shows anexemplary instrument tip 10 including a first electrode 16 and secondelectrode 18, each including a first extension portion 34 a, 34 bextending from a spine portion 42 of the instrument tip. FIG. 8b showsthe instrument tip of FIG. 8a when in use in bipolar mode. As shown, theenergy path 32 from the circuit 38 flows between the first electrode 16and the second electrode 18. Alternatively, as shown in FIG. 8c , inmonopolar mode, the energy path 32 flows from one or more of the firstextension portions 34 a, 34 b located on the spine portion 42 throughtissue (not shown) to a ground pad 40. As shown, during use in monopolarmode, the first and second electrodes are in electrical contact with oneanother such that a single monopolar energy supply can provide for useof both extensions portions.

Alternatively, only one of the first or second electrode may include anextension portion that extends from a spine portion of the instrumenttip. As shown for example at FIG. 9, the first electrode 16 includes anextension portion 34 extending from the spine portion 42 of the firstarm 12 of the instrument tip 10. As shown the second arm 14 includes asecond electrode 18, however the second electrode is free of anyextension portion and thus may not be in receipt of any energy flowduring use of the instrument tip in monopolar mode.

FIG. 10 depicts an alternative instrument tip arrangement wherein thefirst electrode 16 and second electrode 18 are both located on the firstarm 12 of the instrument tip 10. The embodiment shown at FIG. 10 furtherincludes a second arm 14 of the instrument tip that is free of anyelectrode. Both the first arm 12 and the second arm 14 are free of anyelectrode that passes energy in monopolar mode.

Specific examples of prior art tip arrangements for operating in bothmonopolar and bipolar mode are shown at FIGS. 11a-11b and 12a-12b . Asshown for example at FIG. 11a , the instrument tip 10 includes a firstelectrode 16 and second electrode whereby in bipolar mode the circuit 38connects the first and second electrodes 16, 18 and remains unconnectedto any ground pad 40. The first electrode 16 is connected to a powersource via a first connector 17. The second electrode 18 is connected toa power source via a second connector formed of multiple connectorportions 19, 23, 25. Additional connectors 21, 27 are not utilized inthe circuit when in bipolar mode. However, as shown in FIG. 11b , thecircuit 38 is arranged to both provide energy to the first electrode 16and second electrode 18 and also connect via an energy path 32 to aground pad 40 in monopolar mode. Additional connector 21 is connected tosecond connector 25 for forming a circuit that includes the ground pad40. Additional connector 27 is also included in the circuit byconnecting to second connector portion 19. Prior art instrument tiparrangements arranged to provide only monopolar or only bipolarfunctionality are shown at FIGS. 12a and 12b . As shown for example inFIG. 12a , an energy path 32 is formed between the first electrode 16and second electrode 18 when used in bipolar mode while the circuit 38is free of any connection to a ground pad 40. However, in monopolar mode(as shown in FIG. 12b ), the first arm 12 and second arm 14 are closedtoward each other allowing for use of a portion of one or more of thefirst electrode 16 and second electrode in monopolar mode whereby thecircuit 38 no longer connects the first electrode and second electrode,but rather forms and energy path 32 that includes the ground pad 40.These prior arrangements include first and second electrodes that arefree of any portion that extends from the spine portion (e.g., a backedge of the arm) or an exterior side edge of the arm. Thus, the firstand second electrodes are joined to form a common monopolar electrodethat is blunt and free of any extension portion (e.g., blade).

The instrument tip may be arranged to include multiple distinctelectrodes on one arm whereby one electrode passes energy only inbipolar mode and one passes energy only in monopolar mode. Morespecifically, as shown at FIG. 13, the first arm 12 includes a firstelectrode 16 and the second arm 14 includes the second electrode 18. Thefirst arm further includes a third electrode 20 whereby the thirdelectrode is free of any direct connection with the first electrode 16.The third electrode 20 is located along a spine portion 42 of theinstrument tip 10 whereas the first electrode and second electrode arelocated along an inner surface portion 46 a, 46 b of each of the firstarm and second arm. FIG. 14 depicts a similar instrument tip arrangementwhere both the first arm 12 and second arm 14 include multipleelectrodes. Specifically, the second arm 14 includes a fourth electrode48 located along a spine portion 42 of the instrument tip 10, similar inlocation to the third electrode 20 on the first arm 12. In a similarconfiguration, electrodes 20 and 48 are electrically connected via oneor more wires (not shown). Thus electrodes 20 and 48 would act as acommon monopolar electrode to produce a two sided scalpel, similar tothat depicted in FIG. 8c . FIG. 15 depicts yet another instrument tipembodiment including more than two electrodes. The first arm 12 includesa first and second electrode 16, 18 located along the inner surfaceportion 46 of the instrument tip, separated by an insulation portion 28.The first arm also includes a third electrode 20 located along a spineportion 42 of the instrument tip. The first and second electrodes thuspass energy in bipolar mode whereas the third electrode 20 passes energyin monopolar mode. The second arm 14 is free of any conductive element.

FIG. 16 shows an instrument tip arrangement similar to that of FIG. 13.The first arm 12 includes a first electrode 16 and the second arm 14includes the second electrode 18. The first arm further includes a thirdelectrode 20 whereby the third electrode is free of any directconnection with the first electrode 16. The third electrode 20 islocated so that it extends from both opposing terminating side edges 36a, 36 b of the first arm 12 of instrument tip 10 to produce a two sidedscalpel, whereas the first electrode and second electrode are locatedalong an inner surface portion 46 a, 46 b of each of the first arm andsecond arm. FIG. 17 depicts an instrument tip arrangement similar tothat of FIG. 16, however only the third electrode 20 extends from onlyone terminating side edge 36 b of the first arm to produce a one sidedscalpel.

FIG. 18 shows another embodiment similar to FIG. 15 where the firstelectrode 16 and second electrode 18 are located along the inner surfaceportion 46 a of the first arm 12. However, the second arm includes athird electrode 20 located along the spine portion 42 of the instrumenttip.

FIG. 19 shows an instrument tip arrangement including a first electrode16 and second electrode 18 on first arm 12. The instrument tip 10further includes a third electrode 20 (e.g., a conductive element) onthe second arm 14 opposing the first and second electrode. A fourthelectrode 48 is also included, being located along the spine portion 42and utilized during use in monopolar mode. One or more insulationportions 28 may be included to assist in directing the energy path 32during use of the instrument in bipolar mode. FIG. 20 depicts a similararrangement to the instrument tip of FIG. 19, however the fourthelectrode 48 is located on the spine portion 42 on the first arm 12.FIG. 21a is a combination of both FIGS. 19 and 20 whereby both the firstarm 12 and second arm 14 include an electrode (e.g., a fourth electrode48 and fifth electrode 50) on each spine portion 42 of the instrumenttip 10. In a similar configuration, electrodes 20 and 48 areelectrically connected via one or more wires (not shown). Thuselectrodes 20 and 48 would act as a common monopolar electrode. FIG. 21bdepicts the circuit connectivity of the tip arrangement of 21 a. Twomonopolar connector leads 32 a are shown, one originating from each ofthe two monopolar electrodes 48, 50. Two bipolar connector leads 32 bconnect the power source to each of the first electrode 16 and secondelectrode 18.

One or more of the electrodes may be formed from more than one material.In one such embodiment, one or more of the electrodes may be formed fromtwo discrete adjacent conductors including a thermal joint therebetween.As shown for example in FIG. 22a , the first electrode 16 is located onthe first arm 12 and is formed from a first conductor 52 and a secondadjacent conductor 54, thus forming a thermal joint 56 in between thetwo bonded conductors. The second conductor extends from the spineportion 42 of the instrument tip. The second arm 14 includes a secondelectrode 18 located along the inner surface 46 of the second arm. Thusthe first conductor facilitates energy passage in bipolar mode while thesecond conductor facilitates energy passage in monopolar mode. FIG. 22bdepicts the circuit connectivity of the tip arrangement of 22 a. Onemonopolar connector lead 32 a is shown originating from the monopolarelectrode 54. Two bipolar connector leads 32 b connect the power sourceto each of the first electrode 16 and second electrode 18.

FIG. 23 depicts a three electrode system where the first arm 12 includesa first electrode 16 and the second arm includes a second electrode 18and a third electrode 20. A portion 16 a of the first electrode isutilized when the device is in monopolar mode and a second portion 16 bof the first electrode is utilized when the device is in bipolar mode.The energy path 32 a in monopolar mode extends from each electrode orelectrode portion 16 a, 20 utilized for monopolar activity to the groundpad 40. The bipolar leads 32 b extend from a power source to theelectrodes or electrode portions 16 b, 18 utilized when the device inbipolar mode.

FIG. 24 shows a similar embodiment to that of FIGS. 22a and 22b ,however in addition to the first arm 12 including a first electrode 16being formed of multiple distinct conductors 52, 54, the first arm alsoincludes a second standard electrode 18. FIG. 25 shows yet anotheralternative embodiment including both of the first arm 12 and second arm14 including an electrode formed of a first and second conductor 52 a,52 b, 54 a, 54 b having a thermal joint 56 a, 56 b therebetween (e.g.,the first electrode 16 and second electrode 18 are each formed ofmultiple adjacent distinct conductors). FIG. 26 shows an embodimentsimilar to that of FIGS. 22a-22b whereby one electrode (in the case thesecond electrode 18) is formed of multiple distinct conductors. Asshown, the first arm 12 includes a first electrode 16 and the second arm14 includes a second electrode 18, whereby the second electrode isformed of a first conductor 52 bonded to a second conductor 54 connectedby a thermal joint 56. However, unlike FIGS. 22a-22b , the embodiment ofFIG. 26 includes an instrument tip arrangement where the secondconductor 54 extends from an exterior side edge 36 of the second arm 14.

FIGS. 27a and 27b depict a further embodiment whereby the shape of theconductor material creates a thermal joint configuration. Each of thefirst and second electrode 16, 18 are formed of a bottle-neck conductor58 a, 58 b. Each bottle neck conductor includes a first conductorportion (e.g., lobes) 52 a, 52 b and a second conductor portion (e.g.,lobes) 54 a, 54 b and an indented portion 60 a, 60 b in between thefirst and second conductor portions. FIG. 26a shows the opposingconductors when the first arm and second arm are in an open position.FIG. 26b shows the conductors in a closed position.

Any numerical values recited herein include all values from the lowervalue to the upper value in increments of one unit provided that thereis a separation of at least 2 units between any lower value and anyhigher value. As an example, if it is stated that the amount of acomponent or a value of a process variable such as, for example,temperature, pressure, time and the like is, for example, from 1 to 90,preferably from 20 to 80, more preferably from 30 to 70, it is intendedthat values such as 15 to 85, 22 to 68, 43 to 51, 30 to 32 etc. areexpressly enumerated in this specification. For values which are lessthan one, one unit is considered to be 0.0001, 0.001, 0.01 or 0.1 asappropriate. These are only examples of what is specifically intendedand all possible combinations of numerical values between the lowestvalue and the highest value enumerated are to be considered to beexpressly stated in this application in a similar manner.

Unless otherwise stated, all ranges include both endpoints and allnumbers between the endpoints. The use of “about” or “approximately” inconnection with a range applies to both ends of the range. Thus, “about20 to 30” is intended to cover “about 20 to about 30”, inclusive of atleast the specified endpoints.

The disclosures of all articles and references, including patentapplications and publications, are incorporated by reference for allpurposes. The term “consisting essentially of” to describe a combinationshall include the elements, ingredients, components or steps identified,and such other elements ingredients, components or steps that do notmaterially affect the basic and novel characteristics of thecombination. The use of the terms “comprising” or “including” todescribe combinations of elements, ingredients, components or stepsherein also contemplates embodiments that consist essentially of theelements, ingredients, components or steps. By use of the term “may”herein, it is intended that any described attributes that “may” beincluded are optional.

Plural elements, ingredients, components or steps can be provided by asingle integrated element, ingredient, component or step. Alternatively,a single integrated element, ingredient, component or step might bedivided into separate plural elements, ingredients, components or steps.The disclosure of “a” or “one” to describe an element, ingredient,component or step is not intended to foreclose additional elements,ingredients, components or steps.

It is understood that the above description is intended to beillustrative and not restrictive. Many embodiments as well as manyapplications besides the examples provided will be apparent to those ofskill in the art upon reading the above description. The scope of theteachings should, therefore, be determined not with reference to theabove description, but should instead be determined with reference tothe appended claims, along with the full scope of equivalents to whichsuch claims are entitled. The disclosures of all articles andreferences, including patent applications and publications, areincorporated by reference for all purposes. The omission in thefollowing claims of any aspect of subject matter that is disclosedherein is not a disclaimer of such subject matter, nor should it beregarded that the inventors did not consider such subject matter to bepart of the disclosed inventive subject matter.

We claim:
 1. An electrosurgical instrument comprising: (a) a first armcarrying a first and second electrode and having a top edge, a bottomedge and two substantially parallel side edges such that one or more ofthe first and second electrodes extends from the bottom edge and beyondthe top edge of the first arm and wherein the top edge and bottom edgeare substantially parallel to one another and the bottom edge is aninside edge of the first arm adjacent the second arm; (b) a first,second and third insulating portion located on the first arm, the secondinsulating portion arranged so that it is coextensive with and locatedin between the first and second electrode, the first and thirdinsulating portions also arranged coextensive with the first and secondelectrode but free of any contact with the second insulating portion;(c) a second arm opposing the first arm, the second arm carrying asingle conductive element and a first and second insulating portion, thefirst and second insulating portions being free of direct contact withone another; wherein the conductive element is a floating electrode andopposes both the first electrode and the second electrode and whereinthe floating electrode is offset from and does not permanently alignwith the first or second electrode on the first arm.
 2. Theelectrosurgical instrument of claim 1, wherein only the first electrodepasses energy in monopolar mode.
 3. The electrosurgical instrument ofclaim 1, wherein the second insulating portion of the first arm iscentrally located on the first arm and the first insulating portion ofthe second arm is centrally located on the second arm so that the secondinsulating portion of the of the first arm directly opposes the firstinsulating portion of the second arm.
 4. The electrosurgical instrumentof claim 3, wherein the first insulating portion of the second arm andthe second insulating portion of the second arm have a first width and asecond width respectively, the first and second widths aligning parallelto a longitudinal axis of the instrument, and the second width isgreater than the first width.
 5. The electrosurgical instrument of claim3, wherein the second insulating portion of the second arm substantiallysurrounds the conductive element on at least three sides.
 6. Theelectrosurgical instrument of claim 3, wherein the second and thirdinsulating portions of the first arm have a first width and a secondwidth respectively, and the second width is equal to the first width. 7.The electrosurgical instrument of claim 3, wherein the first electrodeis an L-shaped electrode.
 8. The electrosurgical instrument of claim 1,wherein the first arm consists essentially of the first and secondelectrode and the first, second and third insulating portions.
 9. Theelectrosurgical instrument of claim 1, wherein the first insulatingportion of the second arm and the second insulating portion of thesecond arm have a first width and a second width respectively, the firstand second widths aligning parallel to a longitudinal axis of theinstrument, and the second width is greater than the first width. 10.The electrosurgical instrument of claim 1, wherein the second and thirdinsulating portions of the first arm have a first width and a secondwidth respectively, and the second width is equal to the first width.11. The electrosurgical instrument of claim 10, wherein the firstelectrode is an L-shaped electrode.
 12. The electrosurgical instrumentof claim 1, wherein the second arm includes a third insulating portion.13. The electrosurgical instrument of claim 1, wherein one or more ofthe first or second electrode is an L-shaped electrode.